Individual provider Active NPI

Grady Murray, MS, RDN. LDN

  • Registered Dietitian
  • Dothan, AL
National Provider Identifier
1992412746
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
5048 Issued in AL
Practice address
400 Westbrook Rd
Dothan, AL 36303-2971
Phone
(904) 451-7689
NPI assigned
Nov 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 5048 AL Primary

Addresses

Primary practice location

400 Westbrook Rd
Dothan, AL 36303-2971

Mailing address

400 Westbrook Rd
Dothan, AL 36303-2971

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.pineapplepathway.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230207000752 AL Practitioner - Registered Dietitian Or Nutrition Professional 4789055609
I20241113002490 VA Practitioner - Registered Dietitian Or Nutrition Professional 4789055609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lwell LLCGroup PAC ID 5294015004, 11 clinicians

Practice addresses (Care Compare)

1309 Jamestown Rd
Suite 102
Williamsburg, VA 23185-3380
Phone (757) 585-3441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5048ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lwell LLC Dietitian, Registered CurrentSince Oct 17, 2024 Accepting new patients

Locations

3705 Strawberry Plains Rd
Ste B
Williamsburg, VA 23188

1309 Jamestown Rd
Ste 102
Williamsburg, VA 23185
Phone (757) 220-4917

1309 Jamestown Rd
Ste 101
Williamsburg, VA 23185
Phone (757) 220-0645

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1992412746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WESTBROOK RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WESTBROOK RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032971",
            "telephone_number": "904-451-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "GRADY",
        "credential": "MS, RDN. LDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AL",
            "license": "5048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.pineapplepathway.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "contact information",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 Westbrook Rd",
            "city": "Dothan",
            "state": "AL",
            "country_code": "US",
            "postal_code": "363032971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.